Vol.1 ● No.

2 ● 2012 Scientific Research Journal of India 1

Safety Positions for Healthy Sex Following Back Pain

B.Arun.* MPT, CMPT

Abstract: Sexual rehabilitation is never a part of low back rehabilitation in India. Sex is
enjoyment, which should be liked by both the partners, around the world about eight out of
every 10 people has experiencing back pain at some time in their lives, Back pain could cause
difficulty in day-to-day activities. Crisis on partner’s relationship may occur due to
unsatisfactory sex. India a Cultural Rich & Religious country will posse’s mysterious side on
sex and people live in India have closed mouth attitude on sex. Fear about pain during sex is
the first thing which produces fear on sex. The partners should understand the facts on pain
and accommodate the new positions for happy and healthy sex. Variety of recommended
positions is there which help to alleviate pain and gives good support and satisfaction to both
partners.

Key words: Sexual Rehabilitation, Sex, Low Back Pain, Physiotherapy

INTRODUCTION
Sex is pleasure, it is a wonderful
feeling experienced by both partners. The
interpersonal relationship between the
partners brings a firm emotional bond.
Sexual activity has not only produced by
physical, emotional aspects but also
biological aspects in human. The strong
union between the partners may be
wrecked due to a variety of causes. One of
the major causes for the breakage is
unhappiness or dissatisfaction. Pain may
produce disappointments during sexual
activity for both the partners. Pain in the
back is one of the major causes of it.1
Sexuality is an integral part of
normal and healthy relationships. It need
not be the first thing abandoned when you
are bothered by a flare-up of Back pain. 2
Though it is chronic it should not prevent
one from enjoying this part of the
relationship.
Low back pain is the most common
musculoskeletal problem encountered by
most adult population around the world.

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Vol.1 ● No.2 ● 2012 Scientific Research Journal of India 2

Four out of five adults will experience musculoskeletal activity happens.

significant back pain sometime during Literatures supports that the physical
their life. After the common cold, activity during sex produce similar stress
problems caused by the back are the most to back same like lifting, pulling ect.. On
frequent cause of lost work days in adults while performing a vigorous movement in
under the age of forty-five. 3, 7 the pelvic region there is an increased
In the Indian scenario, stress at the back. During anterior tilting of
rehabilitation of back pain concludes when pelvis, the back muscles get compressed
a patient has significant reduction of pain with ligaments and other soft tissues. The
or he has got ability to do all ADL repetitive activity produces more stress to
activities, like day to day activities or the muscles, fascia and bones around the
handling job task ect.. Very few back result in pain.
rehabilitation protocols followed in India People with back pain are usually
focuses on the other parts of rehabilitation. aware which positions could cause pain
Mostly sexual rehabilitation is not the and they are able to find out which
choice of treatment for patient living in positions tend to increase or provoke pain.
India. During vigorous sexual activity there is
Sexual activity is frequently more stress in the lumbar region which can
inhibited by acute pain. Sexual prevent active participation of the
dysfunctions following back pain is the individual and most of the time back pain
common complaint but infrequently ruins their intercourse. A good scheme to
discussed with the therapist. The reasons keep enjoying sex is to choose sensuality
for this closed mouth attitude are multiple. over sexuality.
People who are suffering with it feel that Back pain may ruin sexual life and
they may be the only ones having the may wreck the relationship between the
problem and therefore embarrassed to talk partners. So finding the positions which
about it, even with the doctor or to the help to reduce or minimize pain is
therapist. Some doctors do not feel important for a successful sexual life.
comfortable with the subject, or may not Modified positions are there to reduce
even recognize it as a problem.4 stress in the back and help in safe sex.
Conditions like herniated disk, spinal
WHY PAIN OCCURS DURING SEX? arthritis, & Sacroiliac joint dysfunctions
During the sexual activity between need modification of the positions. 7
the partners there are number of
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Vol.1 ● No.2 ● 2012 Scientific Research Journal of India
Fear of pain may ruin the sexual
life between the partners. Back pain
doesn’t stop the sexual relationship
between the partners. In fact it tells to
accommodate the position to get rid of
pain. Back pain is more of psychological
than physical. The most part of pain
depends on mental status of the person.
HOW TO ASSESS IT?
Various Back disability scale has
an inclusion of sexual relationship
questionnaire. Like, Oswestry has one part
which focuses on sexual relationship. The
scale by Laumann et al., 2005, has come
up with a scale to find out sexual
dysfunction in males. The scale will be
helpful in evaluating the dysfunction.
HOW TO MANAGE IT?
Learning up a new posture or pain
relieving methods like massage or ice prior
to the sex helps in reducing pain and
stress. Usually people with back pain are
aware of which positions those cause pain
and they usually avoid such positions or
movements. 1
People with Back pain should take
a proper rehabilitation measures so that to
cure pain, there are variety of treatment
measures in physiotherapy, no single
treatment is best for all patients.
Combination of various treatment
approaches help in regaining the function
3
as well as reducing the pain in patients.
Apart from it the modified positions will
also help to ease pain.
Physical fitness doesn’t mean that
the partner is able to handle the pain.
Mental fitness is as important as physical
fitness. Understanding the problem
between the partners is very important for
managing for the problem. Having a good
communication and developing a positive
attitude can reduce the anxiety and
apprehension between the partners. Sexual
intercourse provides a natural pelvic tilt
movement which is to be encouraged to
relieve lower back pain. Partners must
create and use of other sexual techniques
that can spare the back, like touching,
atmosphere creation and oral sex. Create
an atmosphere that is very romantic and
not be rushed, relaxed and peaceful. Begin
with oral method and followed with
recommended potions.
RECOMMENDED POSITIONS
No single position is good for all.
Positions depend on the type and cause of
back pain and are best consulted with the
rehabilitation staff. Generally
recommendations include positions like
the Missionary position for both men and
women. 1
If a male partner complains of back
pain, he can be at the top of women will
help to reduce stress at back, or man can
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Vol.1 ● No.2 ● 2012 Scientific Research Journal of India 4

lie at the side of woman either on the front
or at the back. If a female partner
complains, she can be at the top with
variety of positions like in bed or sitting in
a chair. 5
Depending on the type of back
pain, the position alters. For example,
patients with annular bulge will have an
increase in pain during flexion whereas for
a patient with facet problem pain will
increase with extension movements. There
are no hard and fast rules in dealing pain.
General advice given to partners are
placing a towel at the back reduce the
lumbar curvature which helps to prevent
pain. People with back pain can be advised
on good sex through illustration described
by Fahrni in 1976. These illustrations give
guidelines to people with back pain.

ILLUSTRATIONS FOR DIFFERENT POSITIONS

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Vol.1 ● No.2 ● 2012 Scientific Research Journal of India 5

References
1. Danielle Kloeck, “Sex and Back
pain” Webb Physiotherapists Inc,
http://www.physionline.co.za.,
2010, www.spine-dr.com
2. Anthony delitto et al., “exercise
based therapy for Low back pain”
Sep 2010, uptodate.com.
3. Jerry corners, MD. “ Sex and Back
pain” Healthy back institute,
www.losethebackpain.com. 2010
4. Dr.Kraus. Back and neck pain,
www. Lowback - pain .com 2008.
5. Louise F. Lynch “Sex and back
pain information-causes, Diagnosis
and treatments”.
healthynewage.com, 2011.
6. Kamiah A Walkier, “Tips for
Better sex....even with back pain”
www.spineuniverse.com, 2008.
7. Grieves.P, “Common vertebral
joint problems, Elsevier, 2003.

CORRESPONDENCE
*Vice principal, K.G.College of Physiotherapy, Coimbatore 35. Email: barunmpt@gmail.com, Mob:
09994576111.

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